beep t-shirt order form
DESCRIPTION
Farmers Beep t-shirt order formTRANSCRIPT
Beep T-Shirt Order Form
Farmers DairyPO Box 8118Halifax, NSB3K 5Y6
Payment
Credit Card
Visa
Mastercard
Card Number:
Expiration Date:
Cardholder Name:
* $20/Shirt (includes tax& shipping) *Allow 6-8 weeks for delivery
Date:
Customer Information
Name:
Address:
City:
Province:
Postal Code:
Phone
E-mail:
Forms can be submitted by:
Internal Use Only
Ship Date:
Order Completed:
* Mail *Fax(902) 835-1583
*E-mailscan & e-mail to [email protected]
Size Quantity Unit Price Amount
Grand Total
S
M
L
XL
XXL